摘要
目的:大部分肾移植失败的患者体内都存在抗HLA抗体。检测抗供者特异性HLA抗体在肾移植受者体内的表达,并分析其在预测排斥反应中的作用。方法:2006-10/2008-03郑州人民医院器官移植科采用酶联免疫吸附法检测179例肾移植受者血清中的抗供者特异性HLA抗体以及群体反应性抗体水平,群体反应性抗体>10%为阳性,群体反应性抗体阳性受者即致敏受者。检测移植后2个月内早期急性排斥反应的发生率,统计分析群体反应性抗体及抗供者特异性HLA抗体与移植后早期急性排斥反应的关系。结果:肾移植前血清抗供者特异性HLA抗体阳性50例受者的急性排斥反应率发生率为66%,移植前血清群体反应性抗体阳性56例受者的发生率为25%,两者比较差异具有显著性意义(P<0.01),抗供者特异性HLA抗体水平与急性排斥反应的发生具有更强的相关性。移植前血清抗供者特异性HLA抗体阳性受者的急性排斥反应发生率显著高于抗供者特异性HLA抗体阴性受者(66%,11%,P<0.01)。体内含抗HLA-Ⅱ类抗体受者的急性排斥反应发生率显著高于含HLA-Ⅰ类抗体的受者(78.1%,43.8%,P<0.05)。结论:抗供者特异性HLA抗体是肾移植前筛选致敏受者的重要指标,抗供者特异性HLA抗体阳性患者移植后更容易发生急性排斥反应。
OBJECTIVE： Most patients following failure renal transplantation had anti-human leucocyte antigen （HLA） antibody. To detect donor-specific HLA antibody expression in recipients after renal transplantation, and to analyze its effects in prediction of rejection.
METHODS： Anti-donor-specific HLA antibody and panel reaction antibody expression was examined in serum of 179 recipients after renal transplantation using enzyme linked immunosorbent assay at Department of Organ Transplantation, Zhengzhou People＇s Hospital from October 2006 to March 2008. Panel reaction antibody 〉 10% presented positive reaction, and positive panel reaction antibody recipients were sensitization recipients. Incidence of early acute rejection was detected within 2 months following transplantation. Relationship of panel reaction antibody and anti-donor-specific HLA antibody to post-transplantation early acute rejection was statistically analyzed.
RESULTS： The incidence of acute rejection was 66% in 50 recipients with positive pre-transplantation serum anti-donor specific HLA antibody, and the incidence of acute rejection was 25% in 56 recipients with positive pre-transplantation serum panel reaction antibody （P 〈 0.01）. Anti-donor specific HLA antibody level was correlated to acute rejection occurrence. The incidence of acute rejection in recipients with positive pre-transplantation serum anti-donor specific HLA antibody was significantly higher than in recipients with negative anti-donor specific HLA antibody （66%, 11%, P 〈 0.01）. The incidence of acute rejection in recipients with anti-HLA-Ⅱ antibody was significantly higher than in recipients with HLA- Ⅰ antibody （78.1%, 43.8%, P 〈 0.05）. CONCLUSION： Anti-donor specific HLA antibody is a key index for screening sensitization recipient before transplantation. Patients with anti-donor specific HLA antibody easily suffer from acute rejection.
出处
《中国组织工程研究与临床康复》
CAS
CSCD
北大核心
2009年第18期3417-3420,共4页
Journal of Clinical Rehabilitative Tissue Engineering Research
